Pelvic Floor Therapy

Pelvic health physical therapy is the assessment and treatment of various conditions that involve pelvic floor dysfunction or symptoms that manifest in this area. It can be a crucial part of an individual’s complete medical care. The pelvic floor includes muscles, ligaments, nerves and connective tissue. It plays an important role in the body by providing support for the bladder, genitals, uterus and anus.

If you experience any of the symptoms below, you will benefit from pelvic floor physical therapy:

Urgency:

an inability to control a strong, compelling urge to urinate or defecate.

Nocturia:

waking at night repeatedly to urinate.

Constipation:

difficult passage of hard stools less than three times a week, one week out of four.

Frequency:

having to urinate so frequently that your normal routine is affected.

Incontinence:

leakage of urine, gas or feces that is difficult to control.

Chronic Pelvic Pain:

pain within or around the pelvic region without any positive physical diagnosis or medical explanation.

Other common symptoms may include:

Assessment

Before pelvic floor treatment begins, your pelvic health physical therapist will take your full medical history and thoroughly discuss your current problems and symptoms.

With informed consent, your pelvic floor physical therapist will perform a complete physical assessment of the joints and tissues affecting the area. This may include internal and external examinations to identify the affected tissues that may be contributing to your urinary, bowel or pelvic pain symptoms.

Common areas that refer pain to the pelvic region include: the abdomen, lower back, hips, pubic symphysis (the front part of your pubic bones) and sacro-iliac joint (the joint formed by the sacrum and ilium from your low back to your coccyx).

Based on your examination, your pelvic health physical therapist will work with you to put together a plan of care that is specific to your particular goals, symptoms and dysfunction.

Since every person has a unique case, it is important that your treatment is customized to address your specific needs.

Treatment

There are various modes of pelvic floor treatment that are well supported by the scientific literature and can be effective as part of your care. Some of these treatment options are:

1

Education

Education is power! You cannot under-estimate the importance of knowledge. Understanding the anatomy and physiology of the pelvic floor, posture education as well as knowing how to deal with chronic pain symptoms are vital to your recovery. Many clients have improved their symptoms by simply understanding how various aspects such as lifestyle, diet, urinary and bowel hygiene can affect the pelvic floor.

2

Personalized exercise program

As with other musculo-skeletal joints in the body, an individualized exercise program including stretching, strengthening, proper posture and breathing techniques are essential for overall pelvic health. Areas within the pelvic floor and other muscles surrounding the pelvis, thorax and lower limbs will be targeted.

3

Manual therapy

This is presently the preferred method when treating pelvic floor dysfunction. It involves various hands-on techniques such as: stretching, facilitation, soft tissue massage, mobilization as well as connective tissue, myofascial and trigger point release techniques to the affected muscles and tissue.

4

Electrical Muscle Stimulation (EMS)

This is also known as neuromuscular electrical stimulation (NMES). It involves the use of electrical impulses that help facilitate pelvic floor muscle contraction to improve strength. It can also be used to help with symptoms of pelvic pain and urgency.

5

Bladder training

It is important to review your voiding patterns with your therapist to ensure appropriate bladder and bowel habits. This is essential in helping to normalize your overall pelvic function.

6

Other treatments to minimize pain

This may include the use of heat, cold, trans-cutaneous electrical nerve stimulation (TENS), interferential current (IFC), guided imagery, breathing and relaxation techniques. Your therapist will be happy to discuss these other options with you.

7

Biofeedback

This form of treatment is also referred to as Surface Electromyelogram, or surface EMG. It involves using small external electrode sensors much like an EKG, or an internal sensory probe connected to a computer screen for displaying muscle activity. An electrical device is used to help provide auditory or visual feedback on how well or poorly you are using your muscles. This feedback helps you to recruit the muscles more effectively resulting in improved continence or pelvic pain symptoms.